<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

  <div class="form-group">
    <label for="c-avatar" class="control-label col-xs-12 col-sm-2">{:__('Avatar')}:</label>
    <div class="col-xs-12 col-sm-8">
      <div class="input-group">
        <input id="c-avatar" data-rule="" class="form-control" size="50" name="row[avatar]" type="text" value="{$row.avatar}">
        <div class="input-group-addon no-border no-padding">
          <span><button type="button" id="faupload-avatar" class="btn btn-danger faupload" data-input-id="c-avatar" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-avatar"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
          <span><button type="button" id="fachoose-avatar" class="btn btn-primary fachoose" data-input-id="c-avatar" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
        </div>
        <span class="msg-box n-right" for="c-avatar"></span>
      </div>
      <ul class="row list-inline faupload-preview" id="p-avatar"></ul>
    </div>
  </div>
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Realname')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="c-realname" name="row[realname]" class="form-control" value="{$row.realname|htmlentities}" type="text">
    </div>
  </div>
  <div class="form-group">
    <label for="c-gender" class="control-label col-xs-12 col-sm-2">{:__('Gender')}:</label>
    <div class="col-xs-12 col-sm-8">
      {:build_radios('row[gender]', ['1'=>__('Male'), '0'=>__('Female')], $row['gender'])}
    </div>
  </div>
  <div class="form-group">
    <label for="c-birthday" class="control-label col-xs-12 col-sm-2">{:__('Birthday')}:</label>
    <div class="col-xs-12 col-sm-4">
      <input id="c-birthday" data-rule="" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[birthday]" type="text" value="{$row.birthday}">
    </div>
  </div>
  <div class="form-group">
    <label for="c-nurse_time" class="control-label col-xs-12 col-sm-2">{:__('Nurse_time')}:</label>
    <div class="col-xs-12 col-sm-4">
      <input id="c-nurse_time" data-rule="" class="form-control datetimepicker" data-date-format="YYYY" data-use-current="true" name="row[nurse_time]" type="text" value="{$row.nurse_time}">
    </div>
  </div>
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Idcard_name')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="c-idcard_name"  class="form-control" name="row[idcard_name]" value="{$row.idcard_name|htmlentities}" type="text">
    </div>
  </div>
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Idcard_sn')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="c-idcard_sn"  class="form-control" name="row[idcard_sn]" value="{$row.idcard_sn|htmlentities}" type="text">
    </div>
  </div>
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Group_id')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="c-group_id" data-field="name" data-source="user/group/index" class="form-control selectpage" name="row[group_id]" type="text" value="{$row.group_id|htmlentities}">
    </div>
  </div>
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('City_id')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="c-city_id" data-field="city" data-source="city/index" class="form-control selectpage" name="row[city_id]" type="text" value="{$row.city_id|htmlentities}">
    </div>
  </div>
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Intro')}:</label>
    <div class="col-xs-12 col-sm-8">
      <textarea id="c-intro" class="form-control " rows="5" name="row[intro]" cols="50">{$row.intro|htmlentities}</textarea>
    </div>
  </div>
  <div class="form-group layer-footer">
    <label class="control-label col-xs-12 col-sm-2"></label>
    <div class="col-xs-12 col-sm-8">
      <button type="submit" class="btn btn-primary">{:__('OK')}</button>
      <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
    </div>
  </div>
</form>
